Though health care has taken a backseat to Iraq and the economy in this year's presidential campaign, the two candidates do have detailed proposals - with deep differences in underlying philosophy and scope.
Would either proposal solve the three broad issues facing American health care: mushrooming cost, inadequate availability and uneven quality? Is there any way to stimulate market efficiencies to contain costs and get care to the 45 million Americans who don't have insurance?
Three Wharton health care experts doubt either candidate's plan could be enacted as proposed - or would lick all those problems if it were. The problems are so complex, and Americans' expectations of top quality affordable care are so deeply rooted, that it's far from clear there is any satisfactory solution for the near term. "I don't think either of them has a clue how to do it," says Mark V. Pauly, professor of health care systems at Wharton.
The two candidates' proposals emphasize bringing health care to the uninsured and assuring quality care, but they would do little to restrain the growth in costs, adds Wharton health care professor Guy David. "Personally, I don't think any of these plans will go through. The U.S. doesn't have the funds to finance either plan."
While President Bush has been in office, the number of Americans without health care has grown by about five million. The total cost of health care has been growing at about 7% a year, twice the growth rate of gross national product. Roughly 15% of GDP involves health care. "What's troubling is that the rate of increase is so much higher than the rate of increase in GDP," David says.
Obviously, that cannot continue indefinitely, else health care would eventually consume all the nation's output, which would be impossible.
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